Computerized system and method for managing consumables and attachments

ABSTRACT

A system method for determining whether a location on a patient&#39;s body is available for an attachment and/or consumable is provided. A patient identifier is received and the patient&#39;s electronic medical record is accessed. An interactive graphical representation of at least a portion of a human body may be displayed. A selection of a location of the patient&#39;s body from the interactive graphical human body representation may be received and it is determined whether the location is available for an attachment and/or consumable.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of and claims the benefit of priorityto U.S. patent application Ser. No. 11/351,460, filed Feb. 10, 2006,entitled “COMPUTERIZED SYSTEM AND METHOD FOR DETERMINING WHETHER ACONSUMABLE MAY BE SAFELY ADMINISTERED TO A BODY SITE OF A PATIENT.” Thisapplication is related by subject matter to the inventions disclosed inthe commonly assigned U.S. Pat. No. 7,571,851, entitled “COMPUTERIZEDSYSTEM AND METHOD FOR PROCESSING A NUMBER OF ATTACHMENTS ASSOCIATED WITHA PATIENT,” and U.S. Pat. No. 7,506,807, entitled “COMPUTERIZED SYSTEMAND METHOD FOR DETERMINING WHETHER A CONSUMABLE MAY BE SAFELYADMINISTERED TO A BODY SITE OF A PATIENT.”

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not applicable.

BACKGROUND OF THE INVENTION

With the shortage of skilled caregivers and the growing complexity ofthe healthcare industry, the potential for devastating healthcare errorshas increased. Mistakes are often made during the health care processdue to the sheer number of constantly changing caregivers, the growingcomplexity of health care, and opportunities for error. In a hospitalenvironment, post-surgical procedures can be the most dangerous segmentof a patient's hospital stay.

A number of attachments are associated with a patient in the provisionof modern healthcare, particularly in a critical care or intensive caresetting. As the number of attachments and functions provided by theseattachments increases, the potential for adverse and other atypicalevents increases. For instance, particular risks include associatingattachments to the wrong body site location of a patient and determiningwhere to associate attachments.

Other risks include dispensing of medications and other consumables to apatient in an institutional environment. For instance, a medication orother consumable may be administered via an attachment to the incorrectbody site of a patient.

A solution is needed for managing healthcare that is both safe andefficient. The solution should decrease the efforts and steps requiredof caregivers in order to minimize the opportunity for error.

BRIEF SUMMARY OF THE INVENTION

In one embodiment, a method for determining whether a location on apatient's body is available for an attachment is provided. A patientidentifier is received and the patient's electronic medical record isaccessed. An interactive graphical representation of at least a portionof a human body is displayed. A selection of a location of the patient'sbody from the interactive graphical human body representation isreceived and it is determined whether the location is available for anattachment.

In another embodiment a method for displaying graphical representationsindicating locations on a patient's body where one or more attachmentsshould not be placed is provided. A patient identifier identifying apatient is received and the patient's electronic medical record isaccessed. One or more body site locations of the patient where one ormore attachments should not be placed are determined. A representationof at least a portion of a human body for a patient is displayed and afirst graphical representation on the human body representation, thefirst graphical representation indicating a location where attachmentsshould not be placed.

In yet another embodiment, a system for determining whether a locationon a patient's body is available for an attachment is provided. Thesystem comprises a first receiving component for receiving a patientidentifier and a first accessing component for accessing in thepatient's electronic medical record. The system further comprises afirst displaying component for displaying an interactive graphicalrepresentation of at least a portion of a human body and a secondreceiving component for receiving a selection of a location of thepatient's body from the interactive graphical human body representation.A determining component for determining whether the location isavailable for an attachment is also provided.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is described in detail below with reference to theattached drawings figures, wherein:

FIG. 1 is a block diagram illustrating components of a system formanaging patient care in accordance with an embodiment of the invention;

FIG. 2 is a block diagram illustrating components of a system formanaging patient care in accordance with an alternative embodiment ofthe invention;

FIG. 3 is a block diagram illustrating components of a centralinformation system in accordance with an embodiment of the invention;

FIG. 4 is a block diagram illustrating a central database of the centralinformation system in accordance with an embodiment of the invention;

FIG. 5 is a block diagram illustrating a caregiver portable computingdevice in accordance with an embodiment of the invention;

FIG. 6 is a diagram illustrating an identifier in accordance with anembodiment of the invention;

FIG. 7 is a block diagram illustrating a device link micro-server inaccordance with an embodiment of the invention;

FIG. 8 is a flow chart illustrating a method for determining whether apatient body site is proper for an attachment in accordance with anembodiment of the invention;

FIG. 9 is a flow chart illustrating a method for determining whether apatient body site is proper for administering a consumable in accordancewith an embodiment of the invention;

FIG. 10 is a flow chart illustrating a method for displaying graphicalindicia representing current attachments and locations where attachmentsshould not be placed in accordance with an embodiment of the presentinvention;

FIG. 11 is a flow chart illustrating a method for determining whether abody site location for a patient is available in accordance with anembodiment of the present invention; and

FIGS. 12-27 illustrate screen displays in accordance with embodiments ofthe invention.

DETAILED DESCRIPTION OF THE INVENTION

Embodiments of the present invention are directed to a system and methodfor managing patient care in a safe manner so as to minimize caregivererror and maximize efficiency. Having briefly provided an overview ofthe present invention, embodiments of the invention will be discussedwith reference to FIGS. 1-27.

Specifically, with initial reference to FIG. 1, a patient identifier 4may identify a patient 2 and an attachment identifier 8 may identify anattachment 6. A caregiver identifier 12 may identify a caregiver 10. Abody site identifier 5 may identify a body site 3 and a consumableidentifier 9 may identify a consumable 7. A central information system20 and a caregiver portable computing device 60 are capable ofcommunicating over a network 14. The caregiver portable computing device60 is also capable of processing information from the patient identifier4, the body site identifier 5, the attachment identifier 8, theconsumable identifier 9 and the caregiver identifier 12. The caregiverportable computing device 60 can transmit the information to the centralinformation system 20. In this manner, each caregiver 10, each patient2, each body site 3, each attachment 6 and each consumable 7 can betransmitted to the central information system 20. Although allcomponents are shown as communicating over the network 14, peer-to-peercommunication may also be possible. Also, while the components are shownin communication with the central information system, a distributedsystem may be possible. Each of the components of the system isdescribed in greater detail below.

FIG. 3 illustrates an embodiment of the central information system 20.The central information system 20 may include a processing unit 22, aperipheral interface 24, a user interface 26, and a network interface28. The central information system 20 may also include a memory 30. Asystem bus 29 couples the aforementioned components. The centralinformation system 20 may also include a central database 50.

The system memory 30 may include computer storage media in the form ofvolatile and/or nonvolatile memory such as read only memory (ROM) 32 andrandom access memory (RAM) 40. A basic input/output system 34 (BIOS),containing the basic routines that help to transfer information betweenelements within the central information system 20, such as duringstart-up, is typically stored in ROM 32. RAM 40 typically contains dataand/or program modules that are immediately accessible to and/orpresently being operated on by processing unit 22.

By way of example, and not limitation, FIG. 3 illustrates operatingsystem 42, application programs 44, other program modules 46, andprogram data 48. The application programs 44 and other programs 46 maybe described in the general context of computer-executable instructions,such as program modules, being executed by a computer. The applicationsprograms 44 include components for matching patient data, caregiverdata, and medication data in the central database 50 with identifierstransmitted by the caregiver portable computing device 60 (FIG. 1).Furthermore, the application programs 44 include components forgenerating a patient task list. The task lists are based upon knowledgedatabases in the central information system 20 that dictate a particularcourse of care. These tasks lists may be contained within the patientrecords 54 and the caregiver records 58 that are described below withreference to FIG. 4. Generally, program modules include routines,programs, objects, components, data structures, etc. that performparticular tasks or implement particular abstract data types. Moreover,those skilled in the art will appreciate that the invention may bepracticed with other computer system configurations, including hand-helddevices, multiprocessor systems, microprocessor-based or programmableconsumer electronics, minicomputers, mainframe computers, and the like.

The central information system 20 may also include otherremovable/non-removable, volatile/nonvolatile computer storage media. Ahard disk drive may be provided that reads from or writes tonon-removable, nonvolatile magnetic media, a magnetic disk drive thatreads from or writes to a removable, nonvolatile magnetic disk, and anoptical disk drive that reads from or writes to a removable, nonvolatileoptical disk such as a CD ROM or other optical media. Otherremovable/non-removable, volatile/nonvolatile computer storage mediathat can be used in the exemplary operating environment include, but arenot limited to, magnetic tape cassettes, flash memory cards, digitalversatile disks, digital video tape, solid state RAM, solid state ROM,and the like. The hard disk drive is typically connected to the systembus through a non-removable memory interface and magnetic disk drive andoptical disk drive are typically connected to the system bus by aremovable memory interface.

A user may enter commands and information into the central informationsystem through the user interface 26 using input devices such as akeyboard and pointing device, commonly referred to as a mouse, trackballor touch pad. Other input devices may include a microphone, satellitedish, scanner, or the like. These and other input devices are oftenconnected to the processing unit 22 through a user input interface 26that is coupled to the system bus 29, but may be connected by otherinterface and bus structures, such as a parallel port or a universalserial bus (USB). A monitor or other type of display device may also beconnected to the system bus 29 via an interface, such as the peripheralinterface 24. In addition to the monitor, computers may also includeother peripheral output devices such as speakers and printer.

The illustrated central information system 20 is merely an example of asuitable environment for the system of the invention and is not intendedto suggest any limitation as to the scope of use or functionality of theinvention. Neither should the central information system 20 beinterpreted as having any dependency or requirement relating to any oneor combination of components illustrated.

In embodiments, the central information system 20 in the presentinvention operates in a networked environment in conjunction with thenetwork 14 as illustrated in FIG. 1, using logical connections to one ormore remote computers, such as the caregiver portable computing device60. As further described below, the caregiver portable computing device60 may be a personal computer, and typically includes many of theelements described above relative to the central information system 20.

The network 14 may be the Internet and all components of the system maybe accessible over the Internet. Logical connections for networking mayinclude a local area network (LAN) or a wide area network (WAN), but mayalso include other networks. When used in a LAN networking environment,the central information system 20 may be connected to the LAN throughthe network interface 28 or adapter. When used in a WAN networkingenvironment, the central information system 20 typically includes amodem or other means for establishing communications, such as theInternet. The modem, which may be internal or external, may be connectedto the system bus 29 via the user input interface 26, or otherappropriate mechanism.

FIG. 4 illustrates an embodiment of the central database 50 that is acomponent connected with the central information system 20. The centraldatabase 50 may include an identifier index 52 linking the identifiersto all of the identified patients, attachments, sites, consumables, andcaregivers. In the illustrated embodiment, the identifiers are barcodesand the identifier index 52 is a barcode index. However, the identifiersmay include an RF identifier (RFID) or any machine readable identifier.Additionally, the central database 50 may include patient records 54,attachment records 56, caregiver records 58, body site records 61 andconsumable records 63. The patient records 54 may include each patient'streatment history, demographic information and orders entered by aphysician for treatment of each patient. The attachment records 56 mayinclude device settings and capabilities, type of attachment, date andtime of insertion and removal of attachment, monitoring status,subsidiaries of attachments (e.g. lumens), calibration information,waveform status, trouble shooting data, current and prior consumablesbeing administered via the attachment, volume, rate order details, pumpinformation, backpress, bag data and other data relating to theattachment. The caregiver records 58 may include records of assignedtasks for each caregiver in the system. Body site records include thelocation of the body site on the patient, site dressing data, dressingtype, site assessment and availability of the site. Consumable recordsmay include type of consumable (e.g. medication, intravenous fluid),amount, time for administration, dosage/amount to be administered. Theorders and other information can be accessed through the caregiverportable computing device 60 to determine appropriate tasks to beperformed on an identified patient.

FIG. 5 illustrates an exemplary embodiment of the caregiver portablecomputing device 60. The caregiver portable computing device 60 mayinclude a memory 62, a processing unit 64, a battery 66, user interfacetools 68, network interface 70, RF communication tools 59, andidentifier recognition tools 72. The user interface tools 68 mayadvantageously be accessible through a built-in display device 74. Theidentifier recognition tools 72 may be connected with a scanning device78 such as an embedded barcode scanner.

In an embodiment of the invention the caregiver portable computingdevice 60 is a handheld personal digital assistant (PDA). The PDA putsthe data of the central database 50 in the caregiver's hands at thepoint of care. The PDA recognizes identifiers associated with thepatient 2, caregiver 10, attachment 6, body site 3 and consumable 7. ThePDA prompts the caregiver 10 for necessary actions and informationduring the care-giving process.

The caregiver portable computing device 60 is used as verificationdevice and in an embodiment of the invention is a barcode scanner forthe patient identifier 4, body site identifier 5, attachment identifier8, consumable identifier 9 and the caregiver identifier 12. Caregiversmay be provided with varying access levels. For instance, a physicianmay be able to enter tasks, but some less skilled caregivers may not bepermitted such a high access level. In this instance, the caregiverportable computing device 60 is capable of verifying access levelthrough the central database 50 and the caregiver identifier 12.

The caregiver portable computing device 60 accesses the centralinformation system 20 through the network interface 70 and promptscaregivers for scheduled tasks, alerts them to potential error,facilitates documentation, and allows caregivers to review data beforeposting it to central database. Real time updates and current accessorders are available through the caregiver portable computing device 60in real time. While the invention is described in the context of aportable device, in embodiments, a bedside computer may be utilizedalone or in combination with a scanner or other identifier.

FIG. 6 illustrates an embodiment of the patient identifier 4 includingan identifier 11. The identifier 11 is preferably in machine-readableform and may be a scannable barcode or RFID. The patient identifier 4may be in the form of a patient wristband. The caregiver identifier 12preferably also includes the identifier 11. The caregiver identifier 12may be affixed to a caregiver badge in an embodiment of the invention.In embodiments, the body site identifiers 3, the attachment identifiers8 and consumable identifiers 9 also include a machine-readableidentifier as shown. The aforementioned identifiers are linked tospecific data within the central information system database 50.

A number of consumables, attachments and body sites used in medicaltreatment of a patient may be labeled with an identifier such as abarcode. Any item that can be tagged with an identifier can be monitoredby the system of the invention. For instance, a consumable IV bag comingfrom the pharmacy including medications can be labeled at the pharmacywith an identifier such as a barcode. In practice, the caregiver wouldscan the labeled medication before adding it to a pump. The labeledconsumable may be compared with the patient identifier 5 and tasks onpatient record such as the ordered dose, timing, and pump setting. Thetubing attached to the pump and IV bag may also receive an identifier.Since the body site can also be labeled with an identifier, the system,through the caregiver portable computing device 60 looks for a body siteto associate with the identified IV bag. The system compares the bodysite and the consumable to determine if the consumable may be safelyadministered to the body site. In this instance, the caregiver portablecomputing device 60 could provide a green light if all the conditionsare correct and safe or an alert if it is not. Any of a number of othermedical attachments that are attached, inserted, laid upon or otherwisephysically associated with a patient may receive an identifier. Thesedevices include a peripheral IV, a central line, a PA catheter, anarterial line, temporary pacemaker wires, epidural catheters, subduralcatheters, endotracheal tubes, chest tubes, surgical drains and urinarycatheters and implantable devices such as VP shunts, tracheostomies,cardiac pacemakers, medication pumps, implanted central lines, dialysisshunts and vascular filters. Thus, the attachment type may be identifiedby the physical connection or the medical device associated withconnection. Likewise, the products associated with these devices mayalso be identified and used similarly to the pump-IV medicationcombinations described herein.

Labeling each component with an identifier provides a physical structureto make attachments, body sites and consumables part of the careenvironment and part of the workflow. If more than one attachment, bodysite or consumable is present, the system is capable of distinguishingthem from one another because of the aforementioned identifiers. Thisreduces the likelihood of errors, particularly when used in conjunctionwith the central information system of the present invention.

In another embodiment of the system of the invention, with reference toFIG. 2, additional components may be included such as a device linkmicro-server and a patient link micro-server 98. In implementing thesystem of the invention, these micro-server components 98 and 80 mayboth be included or either component 98 or 80 may selectively beimplemented.

FIG. 7 illustrates an embodiment of the device link micro-server 80. Thedevice link micro-server 80 may include a processing unit 82, a networkinterface 84, a user interface 86, and wireless or wired communicationtools 88. The device link micro-server 80 may also include a memory 90including applications 92, task related data 94, and device data 96. Thedevice link micro-server 80 has a device driver within its applications92 and is capable of determining an appropriate communication protocolfor the attached device. The device link micro-server 80 uses standardlanguage protocols to communicate with any device and then converts thatinformation to an appropriate format for user by central informationsystem 20. Although all components are shown as communicating over thenetwork 14, peer-to-peer communication may also be possible.

The patient link micro-server 98 may be substantially identical instructure to the device link micro-server 80 and performs a similarfunction. However, the application programs running on the two devicesmay differ. The patient link micro-server 98 and the device linkmicro-server 80 provide caching or local storage of data. Theinfrastructure of the micro-server devices 80 and 98 allows retention ofdata and management at nursing unit level. Data in the micro-servers 80and 98 may be stored as tagged extensible mark-up language (XML) data.

Both the patient link micro-server 98 and the device link micro-server80 are capable of functioning as web servers. In one embodiment, thepatient link micro-server 98 communicates with the central database 50via XML but may also support HL7 and could be configured to operateusing the Cerner Millennium® architecture of Cerner Corporation ofKansas City, Mo., or in any appropriate manner in the context of theprovided central information system 20. The patient link micro-server 98stores a snapshot of all information about the associated patient, thusproviding back up in case information in the central database 50 becomesinaccessible. The patient link micro-server 98 is capable of functioningas a link between the central database 50 and the processing surroundingcare for the patient 2.

The caregiver portable computing device 60 with the embedded barcodescanner or other identifier recognition mechanism is capable ofcommunication with the device link micro-server 80 and the patient linkmicro-server 98 with an RF signal. Both devices can communicate over thenetwork 14 with the central information system 20 that supplies primarypatient-specific information to the patient link micro-server device 98while the central information system 20 is available.

The micro-servers 80 and 98 are capable of functioning continuouslyduring downtime of the central information system 20 and have theability to automatically re-synchronize with the central informationsystem 20 when it becomes available. The patient link micro-server 98receives updates from the central information system 20 based on designcriteria and sends updates to the central information system 20regarding patient activity and acquired device data. Further, thepatient link micro-server 98 stores a record of activity performed atthe bedside and any data provided to it by adjacent device linkmicro-servers 80. In the absence of the central information system 20,the patient link micro-server 98 will continue to check activitiesagainst its most current activity list and will queue activity updatesand data until the central information system 20 signals itsavailability to accept those updates.

With reference to FIG. 8, a method 800 in a computerized healthcareenvironment for determining whether an attachment may be safely attachedto a body site of a patient is shown. FIG. 8 illustrates further detailsof a method for using the system of the invention in a healthcareenvironment. At step 802, the caregiver identification is input into thesystem. In one embodiment, the caregiver performs self-authentication byscanning the caregiver identifier with the caregiver portable computingdevice. As set forth above, this step may involve swiping or sensing abarcode, RFID, or other machine readable identifier on the caregiversecurity badge. This identifies the caregiver. At step 803, thecaregiver identifier is received by the central information system. Atstep 804, verification to determine whether the caregiver is authorizedto access information about the patient is performed.

At step 806, the patient is identified and input. In one embodiment thecaregiver scans the patient identifier with the caregiver portablecomputing device. This step may involve swiping or sensing a barcode,RFID, or other machine readable identifier. In one embodiment, theidentifier may be located on a patient identification bracelet or on apatient link micro-server. At step 808, the patient identifier isreceived by the central information system. At step 810, patientinformation is accessed or retrieved. The patient information may becontained in a patient's electronic medical record. Patient informationmay include without limitation each patient's treatment history,demographic information and orders entered by a physician for treatmentof each patient

At step 812, the attachment is identified and input. In one embodiment,a caregiver scans the attachment identifier with the caregiver portablecomputing device. Attachments include any number of medical devices thatare attached, inserted, laid upon or otherwise physically associatedwith a patient. These attachments include a peripheral IV, a centralline, a PA catheter, an arterial line, temporary pacemaker wires,epidural catheters, subdural catheters, endotracheal tubes, chest tubes,surgical drains, IV pump, urinary catheters and implantable devices suchas VP shunts, tracheostomies, cardiac pacemakers, medication pumps,implanted central lines, dialysis shunts and vascular filters. Theattachment may be labeled with a barcode, RFID, or other machinereadable identifier that can be scanned or sensed by the caregiverportable computing devices.

At step 814, the attachment identifier is received by the centralinformation system. At step 816, attachment information is accessed orretrieved. The attachment information may include device settings andcapabilities, type of attachment, date and time of insertion and removalof attachment, monitoring status, subsidiaries of attachments (e.g.lumens), calibration information, waveform status, trouble shootingdata, current and prior consumables being administered via theattachment, volume, rate order details, pump information, backpress, bagdata and other data relating to the attachment.

At step 818, the body site location for associated an attachment withthe patient is received. In one embodiment, the caregiver scans the bodysite identifier with the caregiver portable computing device. The bodysite includes a location or area on the patient's body where theattachment is to be attached, inserted, laid upon or otherwisephysically associated with the patient. At step 820, the body siteidentifier is received by the central information system. At step 822,information regarding the body site is accessed. The body siteinformation may include the location of the body site on the patient,site dressing data, dressing type, site assessment and availability ofthe site.

At 824, it is determined whether the attachment identified may beproperly or safely attached, inserted, laid upon or physicallyassociated with the identified body site of the patient. For example, itmay be determined that the identified attachment, such as the pulmonaryartery catheter of FIG. 15, may not be properly or safely physicallyassociated with the body site 1206 of FIG. 12 for the patient because apulmonary artery catheter may not be placed in a peripheral body siteand must be placed central body site, such as central body site 1208 ofFIG. 12. Alternatively, it may be determined that the identifiedattachment, such as peripheral venous catheter of FIG. 15, may not besafely associated with body site 1210 of FIG. 12 for the patient due tothe patient's medical condition or other attachments associated with theidentified body site for the patient.

At step 826, if the attachment may not be properly or safely associatedwith the body site of the patient, the caregiver portable computingdevice displays notification of such. The notification may be in theform an alert or alarm. If the caregiver chooses to override thenotification, the caregiver scans the caregiver identifier and providesan explanation. The caregiver's override is received by the centralinformation system and the override information is stored. If theattachment may be properly or safely associated with the body site ofthe patient, the system can continue without notification or may notifythe caregiver on the caregiver portable computing device.

With reference to FIG. 9, a method 900 in a computerized healthcareenvironment for determining whether a consumable may be safelyadministered to a body site of a patient is shown. FIG. 9 illustratesfurther details of a method for using the system of the invention in ahealthcare environment. At step 902, the caregiver performsself-authentication by scanning the caregiver identifier with thecaregiver portable computing device. As set forth above, this step mayinvolve swiping or sensing a barcode, RFID, or other machine readableidentifier on the caregiver security badge. This identifies thecaregiver. At step 903, the caregiver identifier is received by thecentral information system. At step 904, verification to determinewhether the caregiver is authorized to access information about thepatient is performed.

At step 906, the caregiver scans the patient identifier with thecaregiver portable computing device. This step may involve swiping orsensing a barcode, RFID, or other machine readable identifier. In oneembodiment, the identifier may be located on a patient identificationbracelet or on a patient link micro-server. At step 908, the patientidentifier is received by the central information system. At step 910,patient data are accessed. The patient information may be contained in apatient's electronic medical record.

At step 912, the caregiver scans a consumable identifier with thecaregiver portable computing device. This step may involve swiping orsensing a barcode, RFID, or other machine readable identifier. In oneembodiment, the identifier is attached to the packaging of theconsumable. The consumable identifier is received at step 914 andinformation for the consumable is accessed at step 916. The consumableinformation may include the type of consumable (e.g. medication,intravenous fluid), amount, time for administration, dosage/amount to beadministered.

At step 918, a body site location is identified. The body site locationmay be identified in a variety of ways including input by the caregiverinto the system and swiping or sensing a barcode, RFID, or other machinereadable identifier identifying the body site location with thecaregiver portable computing device. For instance, a caregiver may havescanned a barcode, RFID or other machine readable identifier andassociated it with a body site location for the patient. Later, when theidentifier is scanned with the caregiver portable computing device thesystem will associate the body site identifier with the correct bodysite location for the patient. The identifier to be scanned by thecaregiver portable computing device may be attached to or near the bodysite location.

At step 920 the body site identifier is received and data related to thebody site are retrieved at step 922. At step 924, it is determinedwhether the consumable may be properly or safely administered to thescanned body site of the patient. For example, it may be determined thatthe identified consumable is an inotropic drug that may not be properlyor safely physically administered to the peripheral body site 1206 ofFIG. 12 for the patient because a peripheral site is contraindicated forinotropic drugs.

At step 926, if the consumable may not be properly or safelyadministered with the body site of the patient, the caregiver portablecomputing device displays notification or otherwise communicates thesafety issue to the caregiver. The notification may be in the form analert or alarm. If the caregiver chooses to override the notification,the caregiver scans the caregiver identifier. The caregiver's overrideis received by the central information system and the overrideinformation is stored. If the attachment may be properly or safelyassociated with the body site of the patient, the system can continuewithout notification or may notify the caregiver on the caregiverportable computing device.

With reference to FIG. 10, a method 1000 in a computerized healthcareenvironment for displaying graphical indicia on a human bodyrepresentation, the human graphical indicia indicating locations ofexisting attachments or location of where attachments cannot or shouldnot be placed is shown. FIG. 10 illustrates further details of a methodfor using the system of the invention in a healthcare environment. Atstep 1002, a caregiver identifier is input. In one embodiment, thecaregiver performs self-authentication by scanning the caregiveridentifier with the caregiver portable computing device. As set forthabove, this step may involve swiping or sensing a barcode, RFID, orother machine readable identifier on the caregiver security badge. Thisidentifies the caregiver. However, one of skill in the art willappreciate that the caregiver identifier may be input in any variety ofways.

At step 1003, the caregiver identifier is received by the centralinformation system. At step 1004, caregiver data are retrieved andverification to determine whether the caregiver is authorized to accessinformation about the patient is performed. At step 1006, the patientidentifier is input into the system. In one embodiment, the caregiverscans the patient identifier with the caregiver portable computingdevice. This step may involve swiping or sensing a barcode, RFID, orother machine readable identifier. In one embodiment, the identifier maybe located on a patient identification bracelet or on a patient linkmicro-server.

At step 1008, the patient identifier is received by the centralinformation system. At step 1010, patient data are accessed andretrieved. The patient information may be contained in a patient'selectronic medical record. At step 1012, current attachments for thepatients are determined and identified. At step 1014 it is determinedwhether there are one or more body site locations for the patient whereattachments cannot or should not be placed.

At step 1016, a representation of at least a portion of the human bodyfor the patient is displayed. For instance, the representation may bedisplayed on a caregiver portable computing device or any other display.At step 1018, at least one graphical indicia indicating the location ofan existing attachment to the patient is displayed on the representationof the human body. The graphical indicia are plotted on therepresentation of the human body in the same or similar location thatthe attachment is attached to the patient as described with reference toFIG. 12 below. At step 1020, at least one graphical indicia indicating alocation where an attachment cannot or should not be placed is displayedon the human body representation for the patient. The graphical indiciaare plotted on the representation of the human body in the same orsimilar location where the attachment cannot or should not be attachedto the patient.

With reference to FIG. 12, a screen 1200 displaying a human bodyrepresentation 1202 is shown. The human body representation 1202 isshown for fictitious patient John Doe 1204. Graphical indicia 1206, 1208and 1210 represent attachments currently attached to patient 1204.Graphical indicia 1206 represents a peripheral catheter at theantecubital body site location. Graphical indicia 1208 represents asubclavian or central line at the subclavian body site location andgraphical indicia 1210 represents an arterial attachment at the radialbody site location.

Also displayed on the human body representation 1202 are graphicalindicia 1212 and 1214 representing body site locations where attachmentscannot or should not be placed. Graphical indicia 1212 represents thejugular body site location and graphical indicia 1214 represents thefemoral body site location. In this example, graphical indicia 1212 and1214 indicate that attachments should not be placed in these locationsof patient 1204 because the sites are in use. In this embodiment, thegraphical indicia used to represent current attachment body sitelocation and locations where attachments cannot or should not be placedare different.

Turning now to FIG. 11, a method 1100 for determining whether a bodysite location of a patient is available for an attachment. At step 1102,a patient identifier is input. In one embodiment, the caregiver scansthe patient identifier with the caregiver portable computing device.This step may involve swiping or sensing a barcode, RFID, or othermachine readable identifier. In one embodiment, the identifier may belocated on a patient identification bracelet or on a patient linkmicro-server. At step 1104, the patient identifier is received by thecentral information system. At step 1106, patient information isaccessed. The patient information may be contained in a patient'selectronic medical record.

At step 1108, a representation of least a portion of a human body forthe patient is displayed. At step 1109, a site selection is input by acaregiver. At step 1110 the selection of a location on therepresentation of the human body is received. For example, if acaregiver wants to administer a consumable or place an attachment on thepatient at a particular body site location, the caregiver would selectthe location on the human body representation corresponding to the bodysite location for administration. With reference to FIG. 12, thecaregiver would select the jugular body site location 1212 on the humanbody representation 1202 if the caregiver wanted to administer inotropicto the patient using the jugular body site location 1212.

Referring again to FIG. 11, after receiving the selection of the bodysite location, at step 1112 it is determined whether any attachments maybe properly or safely attached, inserted, laid upon or physicallyassociated with the identified body site of the patient. For example, itmay be determined that any attachments may not be safely associated witha body site for the patient due to the patient's medical condition orother attachments associated with the identified body site for thepatient. If it is determined that attachments may not be properly orsafely attached to the body site location selected, at step 1113,notification of the body site unavailability for attachments isdisplayed. In one embodiment, the notification that attachments may notbe properly or safely associated with the body site of the patient isdisplayed on a caregiver portable computing device. The notification maybe in the form an alert or alarm.

With reference to FIG. 13, a screen 1300 displaying a notification ofthe body site location unavailability for attachments is shown. Thisexemplary screen displays reason 1304 for the unavailability of the bodysite location and the ability for a caregiver to override 1306. Screen1300 allows the caregiver to input the reason for overriding 1306 theunavailability of the body site. In one embodiment, if the caregiverchooses to override the notification, the caregiver scans the caregiveridentifier. The caregiver's override is received by the centralinformation system and the override information is stored.

Referring again to FIG. 11, if the body site location selected isavailable for attachments, at step 1114 it is determined whether anattachment already exists at the body site location. For example, withreference to FIG. 14, if body site location 1410 was selected, it wouldbe determined that an attachment already exists at the body sitelocation. However, if a body site location without graphical indicia isselected, it is determined that an attachment does not exist for thepatient at that body site location.

With reference to FIG. 11, if it is determined that an attachmentalready exists at the selected body site location, at step 1116, datafor the attachment is obtained. The data obtained for the attachment mayinclude femoral line in place. The data obtained at step 1116 isdisplayed at step 1118. The data for the attachment may be displayed inany variety of ways, including on a caregiver portable computing deviceor a computer screen display. After the data for the attachment aredisplayed the system proceeds to step 1124. An exemplary screen 1600displaying attachment data is shown in FIG. 16. For a patient 1602 theattachment data includes the name of the body site location 1604, thetype of attachment 1606, the components of the attachment 1606, 1608 and1610. Whether a component is being added 1614 or removed 1616 from thedocumentation. The data also may include drugs or consumables 1618 thatmay be added 1620 to the component 1612 of the attachment 1606.

Referring again to FIG. 11, if at step 1114 it is determined that anattachment does not already exist at the body site location selected atstep 1120, then the name of the body site is input. With reference toFIG. 14, a screen 1400 displaying a pre-defined list 1402 of body sitelocation names 1404 is shown. A caregiver can chose the correct bodysite location name for the body site location from the list 1402.Alternatively, a caregiver can manually enter in the name of theselected body site location name or by scanning a bar code identifieridentifying the body site location.

Referring again to FIG. 11, at step 1121 data related to the attachmentto be associated with the body site location are received. Informationfor the attachment may be received in a variety of ways. Information maybe received by scanning an identifier on the attachment, accessing adatabase with information for attachment and storing the information forthe attachment. Alternatively, information may be input by a caregiver.With reference to FIG. 15, an exemplary screen 1500 displayinginformation to be input for the attachment is shown. The informationincludes the insertion date/time 1502, the attachment site 1506, thetype of attachment 1507, information regarding subcomponents for theattachment 1508, such as lumens for a catheter. Screen 1500 may also beused for updating information for an existing attachment including thechange date/time 1503, rewiring date/time 1504, removal date/time 1505and monitoring information 1510.

Referring to FIG. 11, at step 1124, the action or task to be completedfor the body site is received. In one embodiment, the action or task maybe selected from a list of tasks 1700 as shown in FIG. 17. Actions mayinclude, but are not limited to, beginning an IV bag, a rate change forthe IV pump, a bolus or infuse event, a wasting event, a site change, adressing change for the site, tubing events and disconnecting events.Actions may include any event associated with care provided related toan attachment. At step 1125, a documentation form for the selectedaction is retrieved and is displayed at step 1126. Exemplary actiondocumentation forms are shown in FIGS. 18-27. At step 1128 documentationdata for the task or event is input by a caregiver and is stored at step1130.

With reference to FIG. 18, a screen 1800 displaying a documentation form1802 for documenting the beginning an IV bag attached to a body site isshown. Data that may be documented for the IV bag in the exemplaryscreen includes the order details 1804, date and time of beginning thebag 1806, the site name 1808 and the volume 1810, rate 1812 andbackpress 1814 of the bag. Furthermore, a caregiver may input additionalcomments 1816 for the action if needed.

With reference to FIG. 19, a screen 1900 displaying a documentation form1902 for documenting beginning an IV bag attached to a body site withweight based dosing is shown. Data that may be documented for the IV bagin the exemplary screen includes the order detail 1904, performance dateand time 1906, weight in kilograms 1908, the site name 1910, the bagnumber 1912, the volume 1914, rate 1916, dose unit 1918 and backpress1920 of the bag. A caregiver may input addition comments and information1922 for the action if needed.

With reference to FIG. 20, a screen 2000 displaying a documentation form2002 for documenting a rate change of an IV bag is shown. Data that maybe documented for the action on the exemplary screen includes the orderdetail 2004, performance date and time 2006, site location 2008, bagnumber 2009, the volume 2010 and rate 2012 of the bag. Additionalcomments and information 2014 may also be input by the caregiver.

With reference FIG. 21, a screen 2100 displaying a documentation form2102 for documenting a rate change of an IV bag with weight based dosingis shown. Data that may be documented for the action on the exemplaryscreen includes the order detail 2104, performance date and time 2106,weight 2108, site 2109, bag number 2110 and the volume 2112, rate 2114,and dose 2116 of the bag. Additional information and comments 2118 mayalso be input as needed.

With reference to FIG. 22, a screen 2200 displaying a documentation form2202 for documenting a bolus or infusion event is shown. Data that maybe documented for the event on the exemplary screen includes the orderdetail 2204, site 2206, bag number 2208, beginning of infusion time2210, end of infusion time 2212, the infuse over 2214, volume 2216 andrate 2218 of the bag. Additional information or comments 2220 may alsobe input.

With reference to FIG. 23, a screen 2300 displaying a documentation form2302 for documenting a wasting event is shown. Data that may bedocumented for the event on the exemplary screen includes the orderdetail 2304, the waste volume 2306, bag number 2308, date and time ofthe event 2310. Additional information or comments 2312 may also beinput.

Referring to FIG. 24, a screen 2400 displaying a documentation form 2402for documenting a site change is shown. Data that may be document forthe site change event on the exemplary screen includes the order detail2404, performance date and time 2406, site the caregiver is changing to2408 and the bag number 2410. A caregiver may also enter additionalinformation or comments 2412 for the event.

With reference to FIG. 25, a screen 2500 displaying a documentation form2502 for documenting a dressing change at a body site is shown. Datathat may be documented for the dressing change even on the exemplaryscreen includes the site name 2504, the dressing change date and time2506, the dressing due date and time 2508, the dressing type 2510, thesite condition 2512, a description of the drainage at the site 2514 andany site interventions 2516. A caregiver may also enter additionalinformation or comments 2518 for the event.

With reference to FIG. 26, a screen 2600 displaying a documentation form2602 for documenting a tubing event is shown. Data that may bedocumented for tubing includes the date and time IV tubing was hung2604, the date and time IV tubing was changed 2606, the date and timepressuring tubing was hung 2608, the date and time pressuring tubing waschanged 2610 and the date and time of pressure bag change 2612. Acaregiver may also enter additional information or comments 2614relating to the event.

Using the above-described system and method, patient, caregiver, bodysite, attachment and consumable identifiers are recorded on thecaregiver portable computing device and transmitted to the centralinformation system 20 either through the patient-link server 98 ordirectly. Caregivers have no opportunity to record data inaccurately aswith currently existing systems. Using network capabilities, a singlecaregiver can monitor multiple parameters for dozens of patients. Thepresently disclosed system can be used to help monitor resources andallows less skilled personnel to handle routine tasks. The invention isnot limited to use in any particular setting. It can be used in anysetting in which multiple patients or caregivers are present.

The disclosed system is safer more efficient that currently used systemsbecause it eliminates unnecessary steps. With the disclosed system, acaregiver can receive directions at a patient's bedside by scanningbarcodes or recognizing other machine-readable identifiers. The scanningcreates the documentation and eliminates the need for an additionalprocess.

While particular embodiments of the invention have been illustrated anddescribed in detail herein, it should be understood that various changesand modifications might be made to the invention without departing fromthe scope and intent of the invention. For example, a traditionalpersonal computer (as opposed to a handheld device) may be located atthe bedside and equipped with a reader device. The embodiments describedherein are intended in all respects to be illustrative rather thanrestrictive. Alternate embodiments will become apparent to those skilledin the art to which the present invention pertains without departingfrom its scope.

From the foregoing it will be seen that this invention is one welladapted to attain all the ends and objects set for above, together withother advantages, which are obvious and inherent to the system andmethod. It will be understood that certain features and sub-combinationsare of utility and may be employed without reference to other featuresand sub-combinations. This is contemplated and within the scope of theappended claims.

1. One or more computer-storage media having computer-executableinstructions embodied thereon, that when executed by a computing device,perform a method for displaying graphical representations indicatinglocations on a patient's body where one or more attachments should notbe placed, the method comprising: receiving a patient identifieridentifying a patient; accessing an electronic medical record for saidpatient; determining one or more body site locations on the patientwhere one or more attachments should not be placed; displaying arepresentation of at least a portion of a human body for the patient;and displaying a first graphical representation on the representation ofat least a portion of a human body, the first graphical representationindicating a location where attachments should not be placed.
 2. Themedia of claim 1, wherein the method further comprises: receiving aselection of a location on the patient's body from the representation ofat least a portion of the human body; and determining whether thelocation is available for an attachment; and if the location is notavailable for the attachment, displaying a tangible notification thatindicates the location is unavailable for the attachment.
 3. The mediaof claim 2, wherein the method further comprises: if the location isavailable for the attachment, displaying a tangible notification thatindicates the location is available for the attachment.
 4. The media ofclaim 1, wherein the method further comprises: receiving a consumableidentifier identifying a consumable; receiving a selection of a locationon the patient's body from the representation of at least a portion ofthe human body; determining whether the consumable may be safelyadministered to the location; and if it is determined that theconsumable may be safely administered to the location, displaying atangible notification indicating that the consumable may be safelyadministered to the location.
 5. The media of claim 4, wherein themethod further comprises: if it is determined that the consumable maynot be safely administered to the location, displaying a tangiblenotification indicating that the consumable may not be safelyadministered to the location.
 6. The media of claim 5, wherein thetangible notification is displayed through the representation.
 7. Themedia of claim 1, wherein the method further comprises: receiving aselection of a location on the patient's body from the representation ofat least a portion of the human body; determining that the location isavailable for an attachment; determining whether the attachment existsin the location; and if the attachment exists, displaying data for theattachment.
 8. One or more computer-storage media havingcomputer-executable instructions embodied thereon, that when executed bya computing device, perform a method in a computerized health careenvironment for determining whether an attachment may be safely attachedto a body site of a patient, the method comprising: receiving a patientidentifier to identify a patient; receiving an attachment identifieridentifying an attachment; receiving a body site identifier identifyingan area of a body of the patient to which the attachment is to beplaced; determining whether the attachment may be safely attached to thebody site of the patient; and displaying a tangible notificationindicating whether the attachment may be safely attached to the bodysite of the patient.
 9. The media of claim 8, wherein the tangiblenotification is displaying a first graphical representation indicatingone or more locations on the patient's body where attachments should notbe placed.
 10. The media of claim 8, wherein the tangible notificationis displaying a first graphical representation indicating one of morelocations on the patient's body where attachments should be placed. 11.The media of claim 8, wherein the method further comprises: receiving aconsumable identifier identifying a consumable; determining whether theconsumable may be safely administered to the area of the body; and if itis determined that the consumable may be safely administered to the areaof the body, displaying a tangible notification indicating that theconsumable may be safely administered to the area of the body.
 12. Themedia of claim 11, wherein the method further comprises: if it isdetermined that the consumable may not be safely administered to thearea of the body, displaying a tangible notification indicating that theconsumable may not be safely administered to the area of the body. 13.The media of claim 8, wherein the method further comprises determiningthat the area of the body is available for the attachment; determiningwhether the attachment exists in the area of the body; and if theattachment exists, displaying data for the attachment.
 14. One or morecomputer-storage media having computer-executable instructions embodiedthereon, that when executed by a computing device, perform a method in acomputerized health care environment for determining whether aconsumable may be safely administered to a body site of a patient, themethod comprising: receiving a patient identifier to identify a patient;receiving a consumable identifier identifying a consumable; receiving abody site identifier identifying a location on a body of the patient towhich the consumable is to be administered; determining whether theconsumable may be safely administered to the body site of the patient;and if it is determined that the consumable may be safely administeredto the body site of the patient, displaying a tangible notificationindicating that the consumable may be safely administered to the bodysite.
 15. The media of claim 14, wherein the body site identifier isreceived through an interactive graphical representation of a humanbody.
 16. The media of claim 15, wherein the tangible notification isdisplayed through the interactive graphical representation.
 17. Themedia of claim 14, wherein the method further comprises: receiving anattachment identifier identifying an attachment; and determining whetherthe attachment may be safely attached to the body site of the patient.18. The media of claim 17, further comprising: displaying a tangiblenotification indicating whether the attachment may be safely attached tothe body site of the patient.
 19. The media of claim 18, wherein thetangible notification is displaying a first graphical representationindicating one or more locations on the patient's body where attachmentsshould not be placed.
 20. The media of claim 18, wherein the tangiblenotification is displaying a first graphical representation indicatingone of more locations on the patient's body where attachments should beplaced.